Millions of children are at risk for developmental deficits in low and-middle-income countries (LMICs).Reviews find that psychosocial interventions for children aged <3 years improve short-run child cognition and language (0.28–0.47 SD). Similarly, a meta-regression analysis of 54 preschool interventions for children aged ≥3 years found significant improvements in children’s cognitive skills (0.15 SD), executive functioning, social–emotional learning, and behavior (0.12 SD). Only 18 of these interventions were from LMICs, with 2 from India, which has the world’s largest population of children attending preschool (36 million children enrolled in Integrated Childhood Development Services [ICDS]). Interventions have had benefits in math and language. However, a survey of 298 Indian preschools found generally poor quality. Although short-run impacts of some interventions fade, some rigorous studies with long-term follow-ups found later benefits in educational attainment, reduced crime, and increased income.
Poor early childhood development in low- and middle-income countries is a major public health problem. Efficacy trials have shown the potential of early childhood development interventions but scaling up is costly and challenging. Guidance on effective interventions’ delivery is needed. In an open-label cluster-randomized control trial, we compared the effectiveness of weekly home visits and weekly mother-child group sessions. Both included nutritional education, whose effectiveness was tested separately.